Exercise Performance With Aficamten vs Metoprolol in Obstructive Hypertrophic Cardiomyopathy

JAMA Cardiology 2026 Open access

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Authors: Gregory D. Lewis, Pablo Garcia-Pavia, Ahmad Masri, Bela Merkely, Michael E. Nassif, M L Pena-Pena, Roberto Barriales-Villa, Ozlem Bilen, Melissa Burroughs, Brian Claggett, Juan Pablo Costabel, Edileide de Barros Correia
+88 more Anne Mette Dybro, Ian J. Kulac, Neal K. Lakdawala, Amy Mann, Martin S. Maron, Shaina McGinnis, Ajith P. Nair, Chloe Newlands, Steen H. Poulsen, Patricia Réant, P Christian Schulze, Scott D. Solomon, Andrew Wang, Regina Lee Sohn, Indrias Berhane, Stephen B. Heitner, Daniel L. Jacoby, Stuart Kupfer, Fady I. Malik, Amy Wohltman, Michael A. Fifer, Perry M. Elliott, MAPLE-HCM Investigators, Ahmad Masri, Andrew Wang, Mark Sherrid, Jacob Kelly, Anjali Owens, Omar Wever-Pinzon, Michael E. Nassif, T Jerin Abraham, Sherif Nagueh, F Rader, Timothy Wong, Matthew Martinez, Neal K. Lakdawala, Milind Desai, Zainal Hussain, Albree Tower-Rader, Sara Saberi, Lubna Choudhury, Sounok Sen, Patrick Bering, Marshall Brinkley, Srihari Naidu, Mathew Maurer, Sumeet Mitter, Ozlem Bilen, Jorge Silva Enciso, Beatrice Musumeci, Michele Emdin, Mattia Targetti, Michelle Michels, Christian Knackstedt, Roberto Barriales-Villa, Pablo García Pavía, Juan Ramón Gimeno Blanes, R Hidalgo Urbano, Luis Miguel Rincón Díaz, Tomás Vicente Vera, David Zemanek, Morten Jensen, Jens Mogensen, J J T Jens Jacob Thune, Henning Bundgaard, Jean‐Noël Trochu, Gilbert Habib, Patricia Réant, Albert Hagege, Damien Logeart, Veselin Mitrovic, Frank Edelmann, Tim Seidler, Benjamin Meder, Paul Christian Schulze, Stephan Stoerk, Tienush Rassaf, Bela Merkely, Michael Arad, Majdi Halabi, Donna Zfat‐Zwas, Xavier Piltz, Artur Oręziak, Wojciech Wojakowski, Alexandra Toste, José Mesquita Bastos, Perry Elliott, M R Mahmod
DOI: 10.1001/jamacardio.2026.1730
Cited by: 1
References: 26

Abstract

Importance: Patients with obstructive hypertrophic cardiomyopathy (oHCM) endure life-altering exercise limitations. Current treatment guidelines recommend β-blockers as first-line therapy primarily based on expert opinion. The Metoprolol vs Aficamten in Patients with Left Ventricular Outflow Tract Obstruction on Exercise Capacity in HCM (MAPLE-HCM) trial characterizes comprehensive exercise response to aficamten monotherapy vs β-blockade (metoprolol). Objective: To determine the effect of aficamten compared with metoprolol across all stages of exercise using 16 quantitative measures in individuals with oHCM. Design, Setting, and Participants: This was a prespecified secondary analysis of the MAPLE-HCM study, a phase 3, randomized, active-control trial conducted from June 2023 to March 2025 with data analyzed between May and July 2025 at 71 sites in North America, South America, Europe, Israel, and China. Patients with symptomatic oHCM with objective evidence of exercise intolerance (peak oxygen uptake [pVO2]

Fields of Study & Subjects

Cardiomyopathy and Myosin Studies Cardiovascular Effects of Exercise Cardiovascular Function and Risk Factors

Publication details

Journal / source
JAMA Cardiology
Publisher
American Medical Association (AMA)
Volume
11
Issue
8
Pages
736–736
Publication date
17 June 2026
Language
EN